HomeMy Public PortalAbout6628 OAK AVE_Mechanical__ r 'COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0303050019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
TR: 4314- FEES LT: 1 BL: .001 P 6628 OAK AV SS:
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801309
ASSESSOR INFORMAT0 NEAREST CROSS STREET: EMPEROR
5382-010-063 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J1 LOCALITY: TEMPLE CITY
21 FIREPLACE 101 - 500 1.00 APL 52.20
30 AIR INLETS/OUTLETS 3.00 UNI 13.05SS ON:
PROCESSED L
32 APPL VENT COTHER) 1.00 UNI 12.90 03/05/03 JK 09/01/03 -
TOTAL FEES 105.90
OWNER: TEL. N0: INAL DATE FINAL BY: CODE:
LEE-KEVIN 0626) 333-5844-
6626 OAK AVENUE
TEMPLE CITY 91780 DESCRIPTION OF WORK
MECHANICAL FOR ADDITION/REMODEL
APPLICANT: TEL. O-
PEN LEE CONSTRUCTION 0626) 333-5844-
15855 REGALADO ST SPECIAL CO DI IO S:
HACIENDA HEIGHTS
CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE
PEN LEE CONSTRUCTION, INC. 0626) 333-5844-
15855 REGALADO ST LIC. NO FAU/WALLTMICE
HACIENDA HGTS CA 91745 669223 B
COMBUSTIO AIR OPENINGS
ARCHITECT ORENGINEER: 0: DUCT 0 y /q,
LIC. NO: C/CO PRESSOR
THERMOSTAT
FIRE DAMPERS
SMOKE CTION DEVICES
COMMERCIAL HOOD
REPORT ID: DPR264 ROUTE TO: BS0508
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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ME 0508 0503250012
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PMD I S:
TR: 4314 LT: 1 BL: .001 6628 OAK AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801309
S SSO 0 B NEAREST CROSS STREET:
5382-010-063 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J1 LOCALITY: TEMPLE CITY, C
30 AIR INLETS/OUTLETS 2.00 UNI 8.70
41 VENTILATION FAN 1.00 FAN 15.75 EXPIRES .
47 ALTER EXIST DUCT SYS 1.00 SYS 27.00 03/25/05 JK 09/21/05
TOTAL FEES 79.20 1
OWNER: TEL. NO: F DATE FIN BY: CODE:
LEE, KEVIN (626) 333-5844-/
6628 OAK AVE !,
TEMPLE CITY CA 91780 DtSCRYPTIOITOTFVm
ALTERARION OF EXISTING DUCT SYSTEM TO ADDITION
APPLICANT: O:
PEN LEE CONSTRUCTION (626) 333-5844-
15855 REGALADO ST SPECIAL CONDITIONS:
HACIENDA HTS 91745
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
PEN LEE CONSTRUCTION (626) 333-5844-
15855 REGALADO ST. LIC. NO PAU/WALL FURNACE
HACIENDA HTS. CA. 91745 669223HIC
COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER: TEL. 0: DUCT WORK
- D
LIC. NO: AC/COMPRESSOR
THERMOSTAT
FIRE DAMPERS
SNOKr DET5CTI-0WTEVrCEr
COM ERCIAL OOD
* ADDITIONAL DATA ON FILE
REPORT ID: DPR264 ROUTE TO: BS0508
TEMPLE CITY PERMIT NO. M17-34276
City of Temple City 1 9701 Las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.templecity. us
Address: 6628 Oak Avenue, Temple City, California
Parcel: 5382-010-063
91780
Permit No: M17-34276
Type: Mechanical Subtype: Subtype: Residential
Description: 5 TON A/C CHANGE OUT, COIL, (1) DUCT
Special
Conditions:
Issue Date: 05-30-2017
Expire Date: 11-26-2017 Extension: Extension:
Permit expires on date shown If: 1) work does not commence, or 2) work Is suspended or abandoned, or 3) applicant falls to obtain
code required inspection.
Owner Krewln Lee
6628 Oak Avenue, Temple City,
California 91780
Applicant Meirav
31225 La Bays Drive, Westlake (818) 732-7876
Eisenberg
Village, California 91362
Contractor Service Champions Inc.DBA Service 3150 East Birch Street, Brea, (714) 777-7777 799170
Champions Heating and Air Conditioning California 92821
• Mechanical Details
Compressor/Furnace I Compressor/ Furnace 0
Compressor/ Furnace 0 Air 1 OR Floor 0
/Etc up to IOOk STU /Etc 100-5001, BTU
/Etc over 500k BTU Inlet/Outlet Area
Qty
Appliance Vent 0 Air Handier up to 0
Air Handler 2-10,000 0 Air Handler 0 Evaporative 0
2,000 CFM
CFM over 10,000 Cooler
CFM
Ventilation Fan 0 Ventilation System 0
Kitchen Hood/Spray 0 Fire Damper 0 Duct 0
Booth Alteration
Fireplace 0
• Fees Total
Plan Check Fees $113.60 Permit Fees $39.66
• Mechanical Inspections
Approval Date Inspector Approval
pats Ins ctor Approval Date Inspector
FAU/Wall AC/Compressor Smoke
Furnace Thermostat
I GPEI Detectors
Combustion Fire Dampers
Commercial
AirHood
/
Openings
�f /0
I to �^ FINAL Wa lo�l—
Duct Work
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from
the Contractors' State License Law for the reason(s) indicated
below by the checkmark(s) I have placed next to the applicable
item(s) (Section 7031.5, Business and Professions Code): Any
city or county that requires a permit to construct, alter, improve,
demolish, or repair any structure, prior to its issuance, also
requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of the
Contractors' State License Law (Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professions
Code) or that he or she is exempt from licensure and the basis
for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars ($500).):
U I, as owner of the property, or my employees with wages as
their sole compensation, will do (J) all of or U portions of the
work, and the structure is not intended or offered for sale
(Section 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of
property who, through employees' or personal effort, builds or
improves the property, provided that the improvements are not
intended or offered for sale. If, however, the building or
improvement is sold within one year of completion, the Owner -
Builder will have the burden of proving that it was not built or
improved for the purpose of sale.).
U I, as owner of the property, am exclusively contracting with
licensed Contractors to construct the project (Section 7044,
Business and Professions Code: The Contractors' State License
Law does not apply to an owner of property who builds or
improves thereon, and who contracts for the projects with a
licensed Contmfor pursuant to the Contractors' State License
Law).
U: I am exempt from licensure under the Contractors' State
License Law for the following reason:
By my signature below I acknowledge that, except for my
personal residence in whicF I must have resided for at least
one year priorl to completion of the improvements covered by
this permit, I c4nnot legally sell a structure that I have built as an
owner -builder If it has not been constructed in its entirety by
licensed contractors. I understand that a copy of the applicable
law, Section 7044 of the Business and Professions Code, is
available upon request when this application is submitted or at
the following Web site: htto:/ANww.leginfo.Ga.aov/calaw.html.
Date:
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, and my
license is in full force and effect. .�.q
License JClass � 7 License No.
Date ;; fie%C9ontractor Signature
WORKERS' COMPENSAT N DEC
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION
COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN
EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION
TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED
FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following
declarations:
I have and will maintain a certificate of consent to self -
insure for workers' compensation, issued by the Director of
Industrial Relations as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
P [icy N
have and will maintain workers' compensation
insurance, as required by Section 3700 of the Labor Code, for
the performance of the work for which this permit is issued. My
wo cars' cornsation ins ran carr�e an4 o i numbl
a0J o �� Q
Carrier Po Icy Number Expiration Date a
Name of Agent Phone Number
I certify that, In the performance of the work for which this
permit is issued, I shall not employ any person in any manner
so as to become subject to the workers' compensation laws of
California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the labor
Code, I shell for ith comply with those provisions
o/
Sl atui of plican Date
LOBBYIST ORDINANCE CERTIFICATION
Complete this section for permits in
Unincorporated Los Angeles County only
This Is to certify that I, as permit applicant, am familiar with the
requirements of Los Angeles County Code Chapter 2.160 at seq.,
(relating to the Los Angeles County Lobbyist Ordinance) and that
all persons acting on behalf of myself complied and will continue
to comply therewith through the application process.
Applicant (Print Name) Applicant Signature
Company Name
Date
JOB ADDRESS
( LOCALITY
HAZARDOUS MATERIAL DECLARATION
Will the applicant or future building occupant handle a hazardous
material or a mixture containing a hazardous material equal to or
greater than the amount specified on the hazardous materials
information guide?
Yes ❑ No ❑
Will the intended use of the building by the applicant or future
building occupant require a permit for construction or
modification from the South Coast Air Quality Management
District (SCAQMD)? See permitting checklist for guidelines.
Yes ❑ No ❑
i
I have read the hazardous materials information guide and the
SCAQMD permitting checklist, I understand my requirem@nts
under the Los Angeles County Code Title 2, Chapter 220'
Sections 220.100 through 220.140 concerning hazardous
material reporting and for obtaining a permit from the SCAQMD.
ASBESTOS NOTIFICATION
❑ Notification letter sent to AQMD and/or EPA
❑ 1 declare that notification of asbestos removal is not
applicable to addressed project.
DECLARATION REGARDING CONSTRUCTION LENDING
AGENCY
I hereby affirm under penalty of perjury that there is a
Construction lending agency for the performance of the work for
which this permit is issued (Section 3097, Civil Code).
Lenders Name
Lender's Address
By my signature below, I certify to,each of the following:
I am the property owner or authorized to act on the
property owner's behalf.
I have read this application and the information I have
provided is correct.
I agree to comply with all applicable city and county
ordinances and state laws relating to building
construction.
I authorize representatives of this county to enter the
above -identified prope or inspection purposes.
Signatu rty Owner or Authorized Agent
Date 5/3 0